Tips & Advice: Incontinence Treatments

Retraining Your Bladder

What is bladder retraining?

One way to treat urinary incontinence is to learn how to retrain your bladder. The goal of bladder retraining is to slowly increase your bladder's capacity so that you decrease the number of times you run to the bathroom. The average adult should urinate every 2-4 hours during the day and once at night. Although bladder retraining can take several weeks, it's important to be persistent. By retraining the bladder, you'll have more control over your voiding habits, which can eliminate those embarrassing accidents on the way to the bathroom.

How can I retrain my bladder?

To start off, keep a voiding diary for a day or two to find a pattern in your bathroom habits. You should set your intervals at least 15 minutes longer than you usually go. For example, if you find yourself going to the bathroom every hour, you should set your interval at every 1 hour and 15 minutes.

Empty your bladder every morning and then again at your set interval of time throughout the day.

As you regain bladder control, gradually increase the time between voidings by 15-minute intervals. Keep increasing until you can go at least 3-4 hours without using the bathroom or without having any bladder leakage.

Note: Force yourself to use the bathroom even if you don't need to at each designated interval. It's important to follow your schedule as it'll help you take more control of your bladder. Drinking small amounts of water throughout the day should keep to keep you on schedule. However, if you feel the sudden urge to go when it's not time to, squeeze those pelvic floor muscles.

How do I use a timed voiding program to retrain my bladder?

You can also learn how to retrain your bladder through timed voiding. This is when you completely empty your bladder on a regular basis to prevent wetting accidents from happening. Timed voiding is an effective technique to help individuals with an overactive bladder and children with daytime wetting problems regain bladder control.

To implement a timed voiding program, create a voiding schedule so that you use the bathroom every two hours throughout the day. You may have to stretch or shorten intervals to accommodate your personal schedule. If you feel a sudden urge before you're scheduled to use the bathroom, relax, stay still, and squeeze your pelvic floor muscles (but not your stomach muscles) for five seconds. Then, even if you don't feel the urge to go when you're scheduled to, try to go anyway. Sticking to your schedule can help you be more successful in retraining your bladder.

What are vibrating watches and how can I use them?

Vibrating watches are discreet reminder devices that can help you practice timed voiding. Reminder watches can be set at specific intervals or at specific times to accommodate your schedule. It's important to remember not to set your watch at times when you know you can't make it to the bathroom. For example, avoid setting alarms during your long commute to work or during an important meeting. You can choose from vibration, sound, or both alerts. When the watch goes off, it's time for a bathroom break.

Watches can also be used for other reminders such as taking medication, keeping meeting schedules, or doing homework or chores. If you don't want to wear a watch, you can try the Invisible Clock II, which is a reminder device worn on your waist band.

How do I choose a reminder watch?

There are several features to look for when selecting a vibrating watch for bathroom or task reminders:

Independent Alarms – This feature allows you to choose specific times of when you want to receive a reminder. Independent alarms allow more flexibility if you have an irregular schedule.

Auto-Restart Countdown Timer – The countdown feature is great for those who have activities that take place on a regular basis. Simply choose any interval of time, whether it be every half hour or every two hours. The watch will count down, vibrate or sound, and then automatically restart to count down again.

Sound/Vibration – Some watches come with sound only, vibration only, or both. The vibration feature works well for those who want a discreet reminder or are in noisy settings.

The MeDose, VibraLITE 8, Malem Vibro-Watch, and VibraLITE 12 watches offer both independent alarms and auto-restart countdown features. These watches can also be set to sound and/or vibration. The VibraLITE 3 only has an auto-restart countdown mode and can sound and/or vibrate. The Timex Midsize Watch doesn't vibrate and only features an auto-restart countdown mode.

Vibrating watches are usually the size of a standard watch due to its vibrating mechanisms. If needed, you can punch additional holes into the watch band or use a replacement band.

Strengthening through Kegel Exercises

What are kegels?

Named after gynecologist Dr. Arnold Kegel, Kegel exercises involve strengthening your pelvic floor muscles to improve stress incontinence, an overactive bladder, and just overall bladder control. Kegels can also improve sexual pleasure. Suitable for all ages, Kegels are commonly used by women, especially after childbirth, however men can also benefit from these exercises.

Exercising the pelvic floor muscles for five minutes, three times a day can make a huge difference to your bladder control. Pelvic strengthening exercises can be done lying, sitting, or standing – however, standing and going about your daily activities while performing Kegels will produce the most effective results.

While you can perform Kegel exercises unaided, many people find Kegels to be more effective with the aid of a Kegel exerciser, which offers resistance to your training regime.

It can take up to six weeks before you regain control of your bladder, so be patient and persistent.

When should I do Kegels?

Kegel exercises can be done anytime and anywhere. However, the best way to do Kegels is by doing them at the same times every day. For example, do the exercises while making your coffee in the morning, eating lunch in the afternoon, and before sleeping at night. The great thing about Kegels is that wherever and whenever you do them, no one will know! Be careful not to overdo the exercises though – as with any other muscle, your pelvic floor muscles need to have a rest before doing another session

Also, make sure to empty your bladder before doing Kegels as a full bladder can weaken the pelvic floor. Women can also perform Kegels before, during, and after pregnancy to strengthen their pelvic floor muscles. When done regularly and consistently, Kegel exercises can not only help men and women regain bladder control, but also produce better sexual gratification.

Performing Kegel Exercises

First, locate your pubococcygeus (PC) muscles. Found in both genders, PC muscles help control urine flow. Many people end up performing kegel exercises incorrectly because they can't locate the right muscles. There are several ways to find them:

Try stopping your urine flow next time you use the bathroom. The muscles used to stop your flow mid-stream are the muscles you'll be using to perform kegels.

Squeeze the muscles you would use if you were trying to stop from passing gas.

For women, stick a finger into your vagina and squeeze as if you were trying to stop urine from coming out. If you feel tightness around your finger, then you're using the correct muscles

Note: It's important that you are only squeezing your pelvic floor muscles when doing kegels, not your stomach, leg, or other muscles.

After finding the right muscles, completely empty your bladder and start out by lying on your back with your knees bent and apart. Squeeze the kegel muscles and hold for three seconds. Let go and repeat this for 10 minutes, at least three times a day.

As your muscles get stronger, change your position to sitting and then standing. The goal is to perform exercises while moving and incorporating them into your daily activities. For example, you may want to do them while you're brushing your teeth in the morning, while you're eating lunch, and while you're washing the dishes at night.

Exercises should become a daily routine. The great thing about kegel exercises is that they are done discreetly so no one will know you're doing them.

Kegel Exercisers for Women

Women can try using vaginal weights, also known as vaginal cones, to help strengthen weakened pelvic floor muscles. Cones are inserted into the vagina, like a tampon, and vary in weights. Once the cones are inserted, you simply squeeze your pelvic floor muscles to keep the weights from slipping out. As your muscles get stronger, you gradually increase the weights, the time used to hold the weights, and the activity level. Vaginal weights can be used while you're working, running errands, or even while watching a movie!

The Kegelmaster is another vaginal exerciser that not only helps strengthen weak pelvic floor muscles, but can also increase sexual pleasure. This device is best used in the reclining position. The plastic device is inserted into the vagina and springs are adjusted according to the amount of resistance that the user develops. As the pelvic floor muscles strengthen, the unit opens and closes more fully and the springs can be adjusted to provide more resistance. Three sets of 30 movements are recommended.

These pelvic floor exercisers can be used by all women, except those who menstruating, are pregnant, or experience pelvic pain.

Lifestyle Changes

Planning Ahead

People who suffer from urinary or fecal incontinence often refrain from leaving the house because they fear of having an embarrassing accident. But with a little bit of planning, you can lead an active life while managing incontinence.

Have all your incontinence supplies on hand by purchasing them online and having them discreetly delivered right to your door. When going out or traveling, find out where the bathrooms are located and keep an extra supply of incontinence products, such as adult diapers and disposable wipes, in your car or bag. A change of clothes can also come in handy since you never know when you'll have that sudden urge or unexpected urine leak.

While you're out having fun, don't forget to follow the incontinence treatment plan recommended by your doctor. This may mean performing kegel exercises or retraining your bladder by taking scheduled bathroom trips. Also, remember to stay hydrated and opt for water instead of caffeinated or carbonated drinks.

Incontinence can be frustrating, but planning ahead can help reduce your worries and help you have a little bit of fun.

The list above does not apply to every individual. Eating chocolate for one person can cause leakage, but for another person, it can have no effect. You can test out which foods and liquids your bladder can tolerate by keeping a voiding diary of what foods/drinks you consume and how it affects your urinating habits. If you can't give up any foods that trigger your bladder, try cutting back or switching to something less caffeinated or acidic.

Staying Hydrated

Many people who experience urinary incontinence have the tendency to limit their fluid intake because they think that by drinking less, they'll have less urine leaks. However, this is not the case and drinking less can actually cause urinary leakage. Restricting fluids can lead to dehydration and constipation, which can irritate the bladder. Instead, use a water bottle to drink small amounts of fluid throughout the day to avoid from drinking too much in one sitting. You should consume about 6-8 cups of fluid everyday - this includes fluid from foods. Remember, water is the best choice for your bladder.

Maintaining a Healthy Weight

Research has found that obesity and excess weight can increase the risk of urinary incontinence. Try losing weight, developing an exercise routine, and maintaining a healthy diet to help prevent incontinence. Keeping a healthy weight also decreases your chances of developing high blood pressure, heart disease, and diabetes.

Quit Smoking

Smoking can lead to chronic coughing, which adds stress to the bladder and triggers leaks. Limiting smoking habits or completely eliminating it can help prevent or reduce incontinence symptoms.